PERCUTANEOUS SONOGRAPHIC GASTROSTOMY - METHOD, INDICATIONS, AND PROBLEMS

Objectives: This study evaluated the application of ultrasound (US) gu idance in the percutaneous placement of gastric feeding tubes in patie nts in whom endoscopic placement of a nutrition tube is not possible, Methods: Thirty-eight patients with upper gastrointestinal obstruction were entered in a prospective study with US-guided nutrition tube app lication. Feasibility of placement, side effects, and nutritional stat es were monitored for a mean follow-up of 4 months, Results: Ultrasoun d allowed rapid puncture after filling of the stomach,vith water throu gh a nasal tube in 34/38 cases. In four cases a total upper gastrointe stinal obstruction required an initial stomach insufflation through a direct puncture. Puncture-related major complications were not observe d. Minor complications during the observation time were one late dislo cation, five cases with broken material after about 6 months (four cou ld be changed by using the Seldinger technique), and two minor local i nfections. The nutrition through feeding tubes stabilized body weight and body composition parameters. Conclusion: The percutaneous sonograp hic gastrostomy (PSG) is a safe and minimally invasive procedure for e nteral nutrition in all cases with upper gastrointestinal obstruction when endoscopic placement of a feeding tube is not possible, Percutane ous sonographic gastrostomy may help to stabilize the nutritional para meters and general condition in patients with malignant diseases. (C) 1998 by Am. Cell. of Gastroenterology.